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Individual

MRS. LAURIE ELLEN CHAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
5844 NW BARRY RD, STE. 110, KANSAS CITY, MO 64154-1465
(816) 880-6100
(816) 746-1226
Mailing address
5844 NW BARRY RD, STE. 110, KANSAS CITY, MO 64154-1465
(816) 880-6100
(816) 746-1226

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2008021543
MO
363LF0000X
Family Nurse Practitioner
Primary
2013002281
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1679919062
MO
Enumeration date
05/13/2013
Last updated
11/06/2015
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